The UK has achieved significant UN targets on its journey to end the HIV epidemic by successfully diagnosing and effectively treating more than 90% of people with the virus.
UK Public Health says there were around 102,000 people with HIV in the UK last year, of whom 8% – 8,200 – are believed to be unaware of their infection.
UNAids has set a target of "90-90-90" for each country, health authorities are challenging to diagnose more than 90% of people with HIV, give 90% treatment and ensure 90% experience viral suppression, which means the amount of HIV in their bodies is maintained very low by antiretroviral drugs they do not spread to other people.
In July, UNAids said Botswana, Cambodia, Denmark, Swaziland, Namibia, and the Netherlands had reached the targets of 90–90–90 and seven more countries were on track to get there.
Britain has now joined their ranks, PHE announced, with 92% diagnosed, 98% of those diagnosed on treatment and 97% on treatment suppressed viral.
A PHE report published before World AIDS Day on Saturday said the new diagnosis continued to decline, from 5,280 in 2016 to 4,363 in 2017. In particular, transmission among gay and bisexual men has declined since 2012.
Campaigners will praise the availability of pre-exposure prophylaxis – an important factor, even though this is not the only one. PreP is an antiretroviral drug that can be taken every day by those at risk because, for example, they have an HIV-positive partner. It has been shown to reduce the chance of their infection being more than 90%.
The HIV advocacy organization took the NHS to court for its refusal to pay PreP and win in 2016. The NHS estimates the drug will cost 20 million pounds per year. As a result, PreP was offered to 10,000 men in a trial.
The PHE report said the use of PreP might be one of the reasons for the decline in infection, but the effects could not be quantified. This study shows a package of actions including condom use, increased testing, especially in sexual health clinics, and those diagnosed using drugs more quickly.
"There is no doubt that prevention efforts to end the HIV epidemic in the UK are working," said Noel Gill, head of STIs and HIV at PHE. "Our efforts must continue to eliminate HIV. With an estimated 8,000 people still unaware of their infection, it is very important that people seek HIV testing if they consider themselves at risk, or accept offers of HIV testing by a health care professional, because early diagnosis is the key to stopping transmission. "
Secretary of health and social care, Matt Hancock, recalled a time when an HIV-positive diagnosis was "effective death penalty".
He said: "Today's report is a touching and powerful reminder of how far we have come. Now in the UK, almost everyone with HIV is not only diagnosed and treated but lives long, healthy, alive – and we are one of only a handful of countries to fulfill this ambitious UN target.
"This seems impossible just a few decades ago, but thanks to the efforts of public health agencies, charities and the NHS to encourage early testing and pioneer high-quality treatment, we are pushing forward in the fight against HIV."
However, there is still great concern about 43% of people diagnosed late, which means they can get sick and get infected with other people before realizing their own HIV status.
Deborah Gold, chief executive of the National Aids Trust, said the group was very happy that all efforts had produced very spectacular results. "This is an extraordinary moment in the struggle against HIV, where everything seems possible. We know what works. We have the tools. With the right political will, investment and public support, we can eliminate HIV as a public health threat and make concrete progress towards the UN target to end HIV-related stigma. "
Ian Green, chief executive of the Terrence Higgins Trust, said that was fantastic news. "But this is far from the end and it is time for us to become more ambitious as we work to end new HIV transmission completely in the UK," he said. He called on the government to commit to ending new infections by 2030.
The Regional Government Association also praised the news but called for a reversal of a £ 600 million cut for the council's public health grant, which funds sexual health services.